scoanet

Stimulus packages targets $19 billion for EHRs.

Although the federal government plans to use $19 billion of the economic stimulus package to facilitate increased adoption of electronic health records (EHRs), some obstacles remain. The Los Angeles Times reports one 10-physician practice that adopted EHRs 3½ years ago has been able to eliminate tens of thousands of manila files and reduce its record-keeping staff from seven to three. The office also eliminated 2½ positions in its billing department because clerks no longer have to review handwritten notes. However, the upfront costs of implementing EHRs can be high—as much as $30,000 per physician, and interoperability across competing records systems remains low. The U.S. Department of Health and Human Services has been tasked with developing a set of standards for EHRs by the end of 2009. Watch for an in-depth article on EHRs in the April issue of AAOS Now.

Read More...

Hospitals seek to employ more physicians as smaller practices disappear.

A commentary published in Physicians News Digest states that current long-term trends favor continued growth of hospital-owned physician practices and changing compensation models. Instead of large salaries and bonuses that were not supported (and in some cases could not be supported) by productivity, compensation is refocusing on strategy and productivity. The author states that factors driving the new model from the physicians’ side include stagnation of reimbursement, a reduction in ancillary revenue, rising practice expenses, and a greater need for scale.
Read more...

An article in the Nov. 2008 issue of AAOS Now examined the issue of changing practice patterns in orthopaedic surgery.
Read "Is the private practice orthopaedist disappearing?"…

Protect your Medicare provider enrollment data by enrolling/updating information online.

The U.S. Centers for Medicare & Medicaid Services (CMS) has set up an Internet-based system, designed to make it easier for physicians and nonphysician providers enrolled in Medicare to protect their enrollment records. The Provider Enrollment, Chair and Ownership System (PECOS), will help providers reduce the risk of having their personal and financial identification numbers (e.g., birth date, Social Security Number, Tax ID Numbers) being stolen and used to commit fraud. PECOS is currently available in more than 30 states and will be expanded to all states by the end of January.
Read More...

Medicaid Announces Service Reductions Due to Budget Cuts

Earlier this month, the Department of Health and Human Services distributed a memo to Medicaid participating physicians in South Carolina concerning a number of reductions in Medicaid benefits due to cuts in the State Budget.  The memo that was distributed has been added to the SCOA Blog.  You may want to review the list of cuts so you are aware of any coverage issues that may impact your patients who are on Medicaid.

Download Medcaid Changes Bulletin

Diagnostic imaging on the rise; insurers respond with tighter scrutiny.

Diagnostic imaging has been called the biggest driver of increasing healthcare costs. A study published in the November/December 2008 issue of the journal Health Affairs reviews data covering about 5 million radiology tests among 377,000 patients enrolled in the Group Health Cooperative in the state of Washington between 1997 and 2006. The authors found that the average total imaging cost per patient/year doubled during the study period, from $229 to $443. Study results showed the per-patient number of computed tomography (CT) scans doubled over the 10 years, and the number of magnetic resonance imaging (MRI) scans tripled across the board, with no single patient group or disease group dominating. According to the researchers, newer tests are being conducted in addition to, rather than instead of, older tests, leading to an increase in costs.
Read More...

FTC delays enforcement of part of the Red Flag Rule for six months.

The Federal Trade Commission (FTC) announced this week that it will "suspend enforcement" until May 1, 2009, of a portion of the Red Flag Rule that affects healthcare providers. The rule states that creditors and financial institutions must develop and implement a written Identity Theft Prevention Program by Nov. 1, 2008. The FTC determined that some entities generally not subject to FTC rules, such as healthcare providers, would need additional time to develop and implement a written program. Numerous healthcare associations have complained to the FTC that physicians are not "creditors," but the FTC is unlikely to exclude healthcare providers from the definition of creditors. Orthopaedic practices may wish to use the extra time to develop and implement a comprehensive Identity Theft Prevention Program.
Read More...

Read AAOS info on Red Flag Regulations...

ICD-10 implementation costs higher than CMS estimates.

AAOS and 11 other healthcare organzations have released a study conducted by Nachimson Advisors, LLC, which suggests that the U.S. Centers for Medicare and Medicaid Services (CMS) has underestimated the cost of implementing the International Classification of Disesases (ICD)-10 code set. According to the study results, the implementation cost for a three-physician practice could be as much as $83,290, while a 100-physician practice might pay more than $2.7 million. CMS has proposed implementing the codes by October 2011.

The AAOS has been monitoring the proposed transition to ICD-10, and is actively engaged to ensure that the transition places as little administrative and cost burden on physician practices as possible.
Read More...

Read the complete study(PDF)...

Reminder: MOC deadlines approaching.

Dec. 15, 2008 is the deadline to satisfy key MOC requirements for diplomates who plan on taking the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification™ (MOC) exam in 2010. Documentation of 120 AMA PRA Category 1 Continuing Medical Education (CME) Credits™ (including 20 credits from one or two scored and recorded self-assessment examinations) must be submitted to the ABOS by the Dec. 15 deadline. If you choose the written examination pathway, you must submit a 3-month surgical case list, or a maximum of 75 consecutive cases, by Dec. 15, 2008. (Note that if you choose the oral examination pathway, you have until Dec. 15, 2009 to submit a 6-month list of surgical cases you performed during 6 consecutive months in 2008 – 2009.)

If your board certification expires in 2009 and you missed the May 1, 2008, application deadline for the recertification exam, you must meet the reporting deadline of Dec. 15, 2008, to enroll in MOC. The exam application is due May 1, 2009. You will not be allowed to complete an application if you do not meet the Dec. 15, 2008, deadline for reporting CME, self-assessment, and case list.

If you are short of the required 120-credits or the 20 credits in scored and recorded self-assessment examinations, the Academy offers a wide range of resources that can help you obtain credits.
Learn more...

For information about the MOC deadlines you must follow and to learn about each MOC component, visit the ABOS online and click on the "Diplomates" tab; then, select the year your certificate will expire from a drop-down menu. You may also call the ABOS at (919) 929-7103.
http://www.abos.org

Medical practices need to develop an Identity Theft Prevention Program by November 1, 2008.

Last month, many in the healthcare industry learned that a 2007 amendment to the Fair and Accurate Credit Transactions Act of 2003 (FACTA) will affect them. Originally, FACTA applied primarily to businesses operating in the financial industries; however, the Federal Trade Commission (FTC) determined that the new 2007 Identity Theft Red Flag Regulations and Guidelines do extend to the healthcare industry. 'Red Flag" applies to any business or organization that does not receive full payment at the time of service or product purchase, and where there may exist an ongoing relationship with the purchaser. This means that orthopaedic practices and other healthcare entities must make a good faith effort to develop and implement a written Identity Theft Prevention Program by November 1, 2008. The elements and scope of an Identity Theft Prevention Program are identified in the article, "Identity Theft Red Flag Regulations and Guidelines: What the new regulations mean for medical practices," found on the AAOS Practice Management Center in the compliance section.
Read More... (member login required)

MGMA believes ICD-10 compliance date is unrealistic.

A proposal by the U.S. Centers for Medicare and Medicaid Services (CMS) calling for full implementation of the International Classification of Diseases (ICD)-10 code sets by Oct. 1, 2011 provides an unrealistic time-frame for the conversion, according to a spokesperson for the Medical Group Management Association (MGMA). The proposed rule for the next generation of the Health Insurance Portability and Accountability Act (HIPAA) electronic transactions must be put in place prior to ICD-10, and MGMA believes that change will take several years for full implementation and testing. The U.S. Health and Human Services Department is currently accepting comments on the proposal.

The AAOS has been monitoring the proposed transition to ICD-10, and is actively engaged to ensure that the transition places as little administrative and cost burden on physician practices as possible.
Read More...